Hubungan Penggunaan Obat Psikoaktif dengan Risiko Jatuh pada Pasien Geriatri di Klinik Penyakit Dalam Rumah Sakit di Madiun

Lily Annisa; I Dewa P. Pramantara; Arianti Arianti; Fita Rahmawati

doi:10.15416/ijcp.2019.8.3.217

Hubungan Penggunaan Obat Psikoaktif dengan Risiko Jatuh pada Pasien Geriatri di Klinik Penyakit Dalam Rumah Sakit di Madiun

Lily Annisa, I Dewa P. Pramantara, Arianti Arianti, Fita Rahmawati

Abstract

Jatuh merupakan salah satu masalah kesehatan serius pada pasien lanjut usia (lansia). Risiko jatuh dapat disebabkan oleh beberapa faktor, salah satunya adalah penggunaan obat psikoaktif yang masuk ke dalam golongan Medication Fall Risk (MFR). Penelitian ini bertujuan untuk mengidentifikasi hubungan penggunaan obat psikoaktif dan karakteristiknya (dosis dan durasi penggunaan obat) terhadap risiko jatuh pada pasien lansia. Penelitian ini dilakukan secara observasional dengan pendekatan cross-sectional. Lokasi penelitian adalah Klinik Penyakit Dalam di dua Rumah Sakit di Kota Madiun (RSUD dr. Soedono Madiun dan RSUD Kota Madiun) pada bulan Oktober sampai Desember 2018. Risiko jatuh diukur menggunakan Time Up and Go (TUG) test. Penelitian diikuti oleh 290 pasien yang terbagi menjadi dua kelompok, yaitu kelompok risiko jatuh rendah (TUG ≤14) sejumlah 231 pasien dan kelompok risiko jatuh tinggi (TUG>14) sejumlah 59 pasien. Hasil penelitan ini menunjukkan adanya hubungan penggunaan obat psikoaktif dengan peningkatan risiko jatuh (adjusted OR 2,158 95% CI 1,176–3,961). Hasil adjusted multivariat menunjukkan dosis 0,1–0,5 DDD/hari atau lebih berhubungan dengan peningkatan risiko jatuh. Dosis obat >0,5 DDD/hari memiliki hubungan yang paling kuat dengan risiko jatuh (adjusted OR 4,463 95% CI 1,120–17,784). Perlu dipertimbangkan risiko dan keuntungan dalam pemberian obat psikoaktif pada pasien lansia. Pemberian dosis efektif seminimal mungkin perlu dipertimbangkan apabila pemberian obat psikoaktif diperlukan.

Kata kunci: Lanjut usia, psikoaktif, time up and go test

Association between Psychoactive Drug Use and Fall Risk in Elderly Patients at Internal Medicine Clinic of Madiun Hospitals

Abstract
Falling is one of serious health problems in elderly patients. The risk of falling can be caused by several factors, one of which is the use of psychoactive drugs that included in the Medication Fall Risk (MFR) class. This study was conducted to identify the relationship between psychoactive drug use and its characteristics (doses and duration of drug use) to the risk of falling in elderly patients. This study was conducted in an observational manner using a cross-sectional approach. This study took place at internal medicine clinic of two hospitals in the city of Madiun (Dr. Soedono Hospital Madiun and Regional Public Hospital of Madiun) from October to December 2018. Fall risk was measured using Timed Up and Go (TUG) test. A total of 290 patients was divided into two groups, namely low-risk group (TUG ≤14, 231 patients) and high-risk group (TUG >14, 59 patients). Results of this study indicated a correlation between the use of psychoactive drugs and an increased fall risks (adjusted OR 2.158 95% CI 1.176–3.961). Adjusted multivariate results showed doses of 0.1–0.5 DDD/day or more was associated with an increased fall risks. Drug doses of >0.5 DDD/day had the strongest relationship with fall risks (adjusted OR 4.463 95% CI 1.120–17.784). It is necessary to consider the risks and benefits of giving psychoactive drugs to elderly patients. Giving a minimum effective dose should be considered if the administration of psychoactive drugs is needed.

Keywords: Elderly, psychoactive, time up and go test

Keywords

Lanjut usia, psikoaktif, time up and go test

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DOI: https://doi.org/10.15416/ijcp.2019.8.3.217